1
|
Foley Davelaar CM, Weber Goff E, Granger JE, Gill DE, Dela Cruz NMR, Sugimoto D. Conservative Treatments of Adolescent Idiopathic Scoliosis: Physical Therapists' Perspectives. Clin Pediatr (Phila) 2024; 63:1132-1138. [PMID: 37942698 DOI: 10.1177/00099228231208609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
This study aimed to examine physical therapists' perspectives in conservative treatments of pediatric patients with adolescent idiopathic scoliosis (AIS). A cross-sectional survey design was used. A validated questionnaire was distributed to physical therapists, and the responses were analyzed. Preferred treatment frequency was 60 minutes (53.8%), twice weekly (41.5%), over 3 to 5 months (44.6%). Top 3 clinical interventions were core and trunk stability enhancement (90.8%), abdominal strengthening (83.1%), and postural correction (80.0%). Top 3 therapeutic goal-setting parameters were activity-based (78.5%), quality-of-life measure-based (56.9%), and participation-based (50.8%). The most common quality-of-life survey used was Oswestry low back pain disability questionnaire (15.6%) followed by Scoliosis Research Society-22 instrument (12.5%). According to our data, physical therapists believe that pediatric patients with AIS can benefit with addressing core and trunk stability, a 60-minute per session, twice weekly, over 3 to 5 months based on activity-based goal-setting and quality-of-life measures using Oswestry questionnaire.
Collapse
Affiliation(s)
- Cassidy M Foley Davelaar
- Department of Orthopaedics and Sports Medicine, Nemours Children's Health, Orlando, FL, USA
- College of Medicine, University of Central Florida, Orlando, FL, USA
| | - Elizabeth Weber Goff
- Division of Physical Therapy, Emory University, Atlanta, GA, USA
- Department of Rehabilitation, Grady Memorial Hospital, Atlanta, GA, USA
| | - Julie E Granger
- Division of Physical Therapy, Emory University, Atlanta, GA, USA
- Performance Rehabilitation & Integrative Sports Medicine, Atlanta, GA, USA
| | - Danielle E Gill
- Division of Physical Therapy, Emory University, Atlanta, GA, USA
- Department of Rehabilitation, Detroit Medical Center-Children's Hospital of Michigan, Troy, MI, USA
| | | | - Dai Sugimoto
- The Micheli Center for Sports Injury Prevention, Waltham, MA, USA
- Faculty of Sport Sciences, Waseda University, Tokyo, Japan
| |
Collapse
|
2
|
Kluszczyński M, Zaborowska-Sapeta K, Kowalski I, Karpiel IS. An Innovative Method for the Conservative Treatment of Idiopathic Scoliosis Using the GraviSpine Device According to the Concept of Spinal Reflex Balance. J Clin Med 2024; 13:4044. [PMID: 39064083 PMCID: PMC11277943 DOI: 10.3390/jcm13144044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 07/04/2024] [Accepted: 07/06/2024] [Indexed: 07/28/2024] Open
Abstract
Objectives: Conservative treatment of idiopathic scoliosis is more effective as a result of early diagnosis in conjunction with the use of specific physiotherapy and bracing techniques. Our aim was to investigate the effectiveness of specific physiotherapy developed according to the concept of spinal reflex balance using the GraviSpine device. This study is a retrospective analysis of prospectively collected data. Methods: A total of 199 patients aged 6-17 years, with a mean age of 11.26 ± 3.35 years, including 168 girls (84.4%) and 31 boys (15.6%), out of a total of 830 patients treated for IS at the Scoliosis Treatment Center in 2014-2019 were included in the assessment, which was conducted according to the inclusion and exclusion criteria. The study group was divided into three age groups. Group A subjects were 6-9 years old; group B, 10-12 years old; and group C, 13-17 years old. The mean follow-up time was 28.71 ± 10.98 months. Treatment outcomes were compared, based on changes in the Cobb angle and the angle of trunk rotation before and after treatment, both within the groups and with respect to sex and curvature location, using the Wilcoxon signed-rank test. Cobb angle changes in patients were classified as improvements, stabilizations, or deteriorations according to the SOSORT criteria. Results: A majority of patients improved or stabilized after treatment, with 67%, 71%, and 90% of subjects in groups A, B, and C, respectively, achieving these results. In group C (the oldest children), a statistically significant reduction of -1.84° ± 6.88° (6.31%) in the mean Cobb angle was achieved after treatment. With regard to sex, improvements and stabilizations accounted for 81% of cases in girls and 61% in boys, respectively. With respect to location, statistically significant reductions in the Cobb angle were noted for thoracic and thoracolumbar spines of -2.2° ± 7.54° (10.17%) p = 0.022 and -2.2° ± 6.58° (6.36%) p = 0.049, respectively. A significant reduction in the mean angle of trunk rotation was obtained in the group and in three curvature locations. Conclusions: Based on the presented research findings, the utilization of the GraviSpine device as an adjunct to specific PSSE (physiotherapeutic scoliosis-specific exercises) physiotherapy and bracing in the management of pediatric patients with mild to moderate scoliosis appears to enhance treatment efficacy.
Collapse
Affiliation(s)
- Marek Kluszczyński
- Department of Health Sciences, Jan Dlugosz University, 4/8 Waszyngtona, 42-200 Częstochowa, Poland
| | - Katarzyna Zaborowska-Sapeta
- Department of Rehabilitation and Orthopedics, School of Medicine, University of Warmia and Mazury in Olsztyn, 10-082 Olsztyn, Poland; (K.Z.-S.); (I.K.)
- Regional Specialized Children’s Hospital in Olsztyn, 10-561 Olsztyn, Poland
| | - Ireneusz Kowalski
- Department of Rehabilitation and Orthopedics, School of Medicine, University of Warmia and Mazury in Olsztyn, 10-082 Olsztyn, Poland; (K.Z.-S.); (I.K.)
- Regional Specialized Children’s Hospital in Olsztyn, 10-561 Olsztyn, Poland
| | - Ilona Sylwia Karpiel
- Łukasiewicz Research Network—Krakow Institute of Technology, The Centre for Biomedical Engineering, Zakopiańska Str. 73, 30-418 Kraków, Poland
| |
Collapse
|
3
|
Wang Z, Lu L, Wang L. Observation on the therapeutic effect of laser acupuncture combined with Schroth therapy on adolescent idiopathic scoliosis. Pak J Med Sci 2024; 40:1174-1179. [PMID: 38952528 PMCID: PMC11190392 DOI: 10.12669/pjms.40.6.8636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 01/29/2024] [Accepted: 02/22/2024] [Indexed: 07/03/2024] Open
Abstract
Objective To explore the clinical effect of laser acupuncture combined with Schroth therapy on adolescent idiopathic scoliosis (AIS). Method This was a retrospective study. Eighty AIS patients were admitted to The Second People's Hospital of Dalian from March 2021 to March 2022 and divided into control group and experimental group according to the treatment method, with 40 cases in each group. The control group received Schroth therapy, and the experimental group received Schroth therapy and laser acupuncture therapy (MLS® laser). All treatments are performed five times a week for four consecutive weeks we compared the clinical effects of the two groups before treatment, six months and 12 months after treatment, and compared the improvement of Cobb angle, axial trunk rotation (ATR), musculoskeletal stiffness(The PulStarG3 system), and gait evaluation (Micro-Electro-Mechanical System(MEMS) between the two groups of patients. Result After four weeks of treatment, the spinal condition of both groups of patients improved. After treatment, the experimental group showed greater improvement in Cobb angle, ATR, spinal range of motion, gait parameters, and clinical efficacy compared to the control group (p<0.05). Conclusion Laser acupuncture combined with Schroth therapy is safe and effective in the treatment of AIS, and is more effective in correcting scoliosis and related problems of AIS.
Collapse
Affiliation(s)
- Zhaoqi Wang
- Zhaoqi Wang, Department of Physiatry, The Second People’s Hospital of Dalian, Dalian 116011, Liaoning, China
| | - Lei Lu
- Lei Lu, Department of Physiatry, The Second People’s Hospital of Dalian, Dalian 116011, Liaoning, China
| | - Liheng Wang
- Liheng Wang, Department of Physiatry, The Second People’s Hospital of Dalian, Dalian 116011, Liaoning, China
| |
Collapse
|
4
|
Parent E. Critically appraised paper: In adolescents with moderate-grade idiopathic scoliosis, nighttime bracing with self-mediated physical activity prevented Cobb angle progression [commentary]. J Physiother 2024; 70:235. [PMID: 38871589 DOI: 10.1016/j.jphys.2024.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Accepted: 05/15/2024] [Indexed: 06/15/2024] Open
Affiliation(s)
- Eric Parent
- Department of Physical Therapy, University of Alberta, Canada
| |
Collapse
|
5
|
Vlădăreanu L, Iliescu MG, Andronache IT, Danteș E. Incidence and Importance of Peripheral Vestibular Dysfunction in Adolescent Idiopathic Scoliosis. CHILDREN (BASEL, SWITZERLAND) 2024; 11:723. [PMID: 38929302 PMCID: PMC11201755 DOI: 10.3390/children11060723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 06/05/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024]
Abstract
Adolescent idiopathic scoliosis (AIS) is a common form of scoliosis. As the name suggests, etiopathogenesis is not clearly defined, so treatment is still anchored in the musculoskeletal theory and correction/prevention of high Cobb angle values. This study aimed to determine whether there is any connection between developing scoliotic curvature and a positive history of motion sickness as a symptom of a peripheral vestibular dysfunction/deficit, and if vestibular rehabilitation exercises could be integrated into the treatment plan. The study was conducted over 12 months on a selected population of 159 patients to evaluate or treat scoliotic curvatures in a private clinic. The collected data were analyzed using IBM SPSS Statistics 25 and illustrated using Microsoft Office Excel/Word 2021. Patients with peripheral vestibular dysfunction had significantly higher Cobb angle values when compared to patients with a negative result in an instrumental test for peripheral vestibular dysfunction. Motion sickness was considerably more associated with peripheral vestibular dysfunction, and a positive Fukuda stepping test was associated with a positive history of motion sickness. Adolescent idiopathic scoliosis with higher Cobb angles is related to positive motion sickness history as part of peripheral vestibular dysfunction. Conservative treatment for scoliosis could incorporate sensory integration techniques, and a positive history of motion sickness could be an indicator of a higher risk of progression in adolescent idiopathic scoliosis.
Collapse
Affiliation(s)
- Liliana Vlădăreanu
- Doctoral School of Medicine, “Ovidius” University of Constanta, 1 University Alley, 900470 Constanta, Romania; (L.V.); (I.T.A.); (E.D.)
- Rehabilitation Department, Faculty of Medicine, “Ovidius” University of Constanta, 1 University Alley, 900470 Constanta, Romania
- Pediatric Neurorehabilitation Department, Techirghiol Balneal and Rehabilitation Sanatorium, 34-41 Climescu Blvd., 906100 Techirghiol, Romania
| | - Mădălina Gabriela Iliescu
- Doctoral School of Medicine, “Ovidius” University of Constanta, 1 University Alley, 900470 Constanta, Romania; (L.V.); (I.T.A.); (E.D.)
- Rehabilitation Department, Faculty of Medicine, “Ovidius” University of Constanta, 1 University Alley, 900470 Constanta, Romania
- Pediatric Neurorehabilitation Department, Techirghiol Balneal and Rehabilitation Sanatorium, 34-41 Climescu Blvd., 906100 Techirghiol, Romania
| | - Iulia Tania Andronache
- Doctoral School of Medicine, “Ovidius” University of Constanta, 1 University Alley, 900470 Constanta, Romania; (L.V.); (I.T.A.); (E.D.)
- Department of Rheumatology, Internal Medicine Clinic, “Alexandru Gafencu” Military Emergency Hospital Constanta, Mamaia Blvd., 900527 Constanța, Romania
| | - Elena Danteș
- Doctoral School of Medicine, “Ovidius” University of Constanta, 1 University Alley, 900470 Constanta, Romania; (L.V.); (I.T.A.); (E.D.)
- Rehabilitation Department, Faculty of Medicine, “Ovidius” University of Constanta, 1 University Alley, 900470 Constanta, Romania
- Clinical Hospital of Pulmonology, 40 Sentinelei Street, 900002 Constanta, Romania
| |
Collapse
|
6
|
Ohrt-Nissen S, Heegaard M, Andersen T, Gehrchen M, Dahl B, Tøndevold N. Bracing in severe skeletally immature adolescent idiopathic scoliosis: does a holding strategy change the surgical plan? EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2024; 33:2457-2462. [PMID: 38607405 DOI: 10.1007/s00586-024-08246-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 02/28/2024] [Accepted: 03/28/2024] [Indexed: 04/13/2024]
Abstract
PURPOSE The purpose of the study was to assess the changes in flexibility during night-time bracing in skeletally immature adolescent idiopathic scoliosis (AIS) with curves in the surgical range. MATERIALS AND METHODS We included a consecutive cohort of 89 AIS patients with curves ≥ 45° and an estimated growth potential. All patients were eventually treated with fusion surgery, and all patients had side-bending radiographs prior to both bracing and surgery. Curves were classified as structural or non-structural curves according to Lenke at both timepoints. RESULTS The main curve progressed by a mean of 12 ± 10° and the secondary curve by 8 ± 8°. Flexibility of the main curve decreased from 50 ± 19% to 44 ± 19% (p = 0.001) and the underlying curve from 85 ± 21% to 77 ± 22% (p = 0.005). In 69 patients (79%), the Lenke category did not progress during bracing. In 14 patients (15%), the progression in Lenke type occurred in the thoracic region (i.e., Lenke type 1 to type 2), while six patients (7%) progressed in the lumbar region (i.e., type 1 to type 3). In the 69 patients that did not progress, we found that the last touched vertebra moved distally by one or two levels in 26 patients. CONCLUSIONS This is the first study to describe that curve flexibility decreases during bracing in severe AIS. However, this had only a modest impact on the surgical strategy. Bracing as a holding strategy can be applied, but the risk of losing flexibility in the lumbar spine should be outweighed against the risks of premature fusion surgery.
Collapse
Affiliation(s)
- Søren Ohrt-Nissen
- Spine Unit, Department of Orthopedic Surgery, Rigshospitalet University of Copenhagen, Inge Lehmansvej 6, 2100, Cph E, Copenhagen, Denmark.
| | - M Heegaard
- Spine Unit, Department of Orthopedic Surgery, Rigshospitalet University of Copenhagen, Inge Lehmansvej 6, 2100, Cph E, Copenhagen, Denmark
| | - Thomas Andersen
- Spine Unit, Department of Orthopedic Surgery, Rigshospitalet University of Copenhagen, Inge Lehmansvej 6, 2100, Cph E, Copenhagen, Denmark
| | - M Gehrchen
- Spine Unit, Department of Orthopedic Surgery, Rigshospitalet University of Copenhagen, Inge Lehmansvej 6, 2100, Cph E, Copenhagen, Denmark
| | - B Dahl
- Spine Unit, Department of Orthopedic Surgery, Rigshospitalet University of Copenhagen, Inge Lehmansvej 6, 2100, Cph E, Copenhagen, Denmark
| | - N Tøndevold
- Spine Unit, Department of Orthopedic Surgery, Rigshospitalet University of Copenhagen, Inge Lehmansvej 6, 2100, Cph E, Copenhagen, Denmark
| |
Collapse
|
7
|
You MJ, Lu ZY, Xu QY, Chen PB, Li B, Jiang SD, Jiang LS, Xia J, Zheng XF. Effectiveness of Physiotherapeutic Scoliosis-Specific Exercises on 3-Dimensional Spinal Deformities in Patients With Adolescent Idiopathic Scoliosis: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2024:S0003-9993(24)00953-5. [PMID: 38719166 DOI: 10.1016/j.apmr.2024.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 01/18/2024] [Accepted: 04/26/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVE To investigate the effects of physiotherapeutic scoliosis-specific exercises (PSSE) on coronal, horizontal, and sagittal deformities of the spine in adolescent idiopathic scoliosis (AIS) as well as how curve severity, intervention duration, and intervention type could modify these effects. DATA SOURCES Data sources included PubMed, Web of Science, Embase, Cochrane Library, and Scopus databases, which were searched from their inception to September 5, 2023. STUDY SELECTION Clinical controlled trials reporting the effects of PSSE on the Cobb angle, angle of trunk rotation (ATR), thoracic kyphosis (TK), or lumbar lordosis in patients with AIS aged 10-18 years. The experimental groups received PSSE; the control groups received standard care (observation or bracing) or conventional exercise such as core stabilization exercise, Pilates, proprioceptive neuromuscular facilitation, and other nonspecific exercises. DATA EXTRACTION Two researchers independently extracted key information from eligible studies. The quality of the studies was assessed using the Cochrane Handbook version 5.1.0 risk of bias assessment and the JBI Center for Evidence-Based Health Care (2016) of quasi-experimental research authenticity assessment tool. The level and certainty of evidence were rated according to the Grading of Recommendations, Assessment, Development, and Evaluation framework. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The protocol for this study was registered in PROSPERO (CRD42023404996). DATA SYNTHESIS Twelve randomized controlled trials (RCTs) and 5 non-RCTs were meta-analyzed separately. The results indicated that compared with other nonsurgical management, PSSE significantly improved the Cobb angle, ATR, and TK, whereas the lumbar lordosis improvement was not statistically significant. Additionally, the efficacy of PSSE on Cobb angle was not significant in patients with curve severity ≥30° compared with controls. Nevertheless, the pooled effect of PSSE on Cobb angle was not significantly modified by intervention duration and intervention type and that on ATR was not significantly modified by intervention duration. The overall quality of evidence according to Grading of Recommendations, Assessment, Development, and Evaluation was moderate to low for RCT and very low for non-RCT. CONCLUSIONS PSSE exhibited positive benefits on the Cobb angle, ATR, and TK in patients with AIS compared with other nonsurgical therapies. In addition, the effectiveness of PSSE may be independent of intervention duration and intervention type but may be influenced by the initial Cobb angle. However, more RCTs are needed in the future to validate the efficacy of PSSE in moderate AIS with a mean Cobb angle ≥30°. Current evidence is limited by inconsistent control group interventions and small sample size of the studies.
Collapse
Affiliation(s)
- Meng-Jia You
- Spine Center, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai; Department of Medical Technology (Direction of Rehabilitation Therapy), School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Ze-Yu Lu
- Spine Center, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai
| | - Qing-Yin Xu
- Spine Center, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai
| | - Peng-Bo Chen
- Spine Center, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai
| | - Bo Li
- Spine Center, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai
| | - Sheng-Dan Jiang
- Spine Center, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai; Department of Medical Technology (Direction of Rehabilitation Therapy), School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Lei-Sheng Jiang
- Spine Center, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai; Department of Medical Technology (Direction of Rehabilitation Therapy), School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Jun Xia
- Department of Medical Technology (Direction of Rehabilitation Therapy), School of Exercise and Health, Shanghai University of Sport, Shanghai, China.
| | - Xin-Feng Zheng
- Spine Center, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai; Department of Medical Technology (Direction of Rehabilitation Therapy), School of Exercise and Health, Shanghai University of Sport, Shanghai, China.
| |
Collapse
|
8
|
Baumann AN, Orellana K, Oleson CJ, Curtis DP, Cahill P, Flynn J, Baldwin KD. The impact of patient scoliosis-specific exercises for adolescent idiopathic scoliosis: a systematic review and meta-analysis of randomized controlled trials with subgroup analysis using observational studies. Spine Deform 2024; 12:545-559. [PMID: 38243155 DOI: 10.1007/s43390-023-00810-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 12/16/2023] [Indexed: 01/21/2024]
Abstract
PURPOSE Adolescent idiopathic scoliosis (AIS) is a common pediatric spinal deformity frequently treated with patient scoliosis-specific exercises (PSSE). The purpose of this study is to perform a systematic review and meta-analysis of randomized controlled trials and sensitivity analysis of observational studies to determine the impact of PSSE on outcomes for AIS. METHODS A systematic review and meta-analysis on impact of PSSE for patients with AIS was performed. Databases used included PubMed, CINAHL, MEDLINE, Cochrane, and ScienceDirect database inception to October 2022. Inclusion criteria included use of PSSE, patient population of AIS, and full text. RESULTS A total of 26 articles out of 628 initial retrieved met final inclusion criteria (10 randomized controlled trials (RCTs), 16 observational studies). Total included patients (n = 2083) had a frequency weighted mean age of 13.2 ± 0.9 years and a frequency weighted mean follow-up of 14.5 ± 20.0 months. Based on only data from RCTs with direct comparison groups (n = 7 articles), there was a statistically significant but clinically insignificant improvement in Cobb angle of 2.5 degrees in the PSSE group (n = 152) as compared to the control group (n = 148; p = 0.017). There was no statistically significant improvement in Cobb angle when stratified by small curve (< 30 degrees) or large curve (> 30 degrees) with PSSE (p = 0.140 and p = 0.142, respectively). There was no statistically significant improvement in ATR (p = 0.326) or SRS-22 score (p = 0.370). CONCLUSION PSSE may not provide any clinically significant improvements in Cobb angle, ATR, or SRS-22 scores in patients with AIS. PSSE did not significantly improve Cobb angle when stratified by curve size. LEVEL OF EVIDENCE Level I.
Collapse
Affiliation(s)
- Anthony N Baumann
- Department of Rehabilitation Services, University Hospitals, Cleveland, OH, USA
- College of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA
| | - Kevin Orellana
- Department of Orthopedics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Caleb J Oleson
- College of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA
| | - Deven P Curtis
- College of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA
| | - Patrick Cahill
- Department of Orthopedics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - John Flynn
- Department of Orthopedics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Keith D Baldwin
- Department of Orthopedics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA.
| |
Collapse
|
9
|
Karavidas N, Iakovidis P, Chatziprodromidou I, Lytras D, Kasimis K, Kyrkousis A, Apostolou T. Physiotherapeutic Scoliosis-Specific Exercises (PSSE-Schroth) can reduce the risk for progression during early growth in curves below 25°: prospective control study. Eur J Phys Rehabil Med 2024; 60:331-339. [PMID: 38502554 PMCID: PMC11112511 DOI: 10.23736/s1973-9087.24.08177-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 12/22/2023] [Accepted: 03/07/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND The main treatment aim in mild scoliosis is to prevent progression and if possible, to avoid bracing. Physiotherapeutic Scoliosis Specific Exercises (PSSE) are curve pattern specific exercises, based on 3D self-correction and activities of daily living training. AIM The objective of this study was to evaluate the efficacy of PSSE - Schroth, as an exclusive treatment, during the riskiest period of rapid growth. DESIGN Prospective control study. SETTING Outpatient treatment. POPULATION Adolescents with scoliosis. METHODS One hundred and sixty-three patients (148 girls,15 boys; mean age 12.6 years, Risser sign 1.1, thoracic (Th) Cobb angle 20.8° and lumbar/thoracolumbar (L/TL) Cobb angle 20.7°) performed PSSE - Schroth exercises in our clinic. They were asked to regularly attend supervised sessions and to follow a home-program at least 5 times per week. Our inclusion criteria were Cobb angle 15°-25°, Risser 0-2 and angle trunk rotation (ATR) >5°, measured by scoliometer. The outcome parameters were the Cobb angle before and after the intervention (improvement or progression were defined as angle difference more than 5°) and the number of patients that finally needed a brace. Average follow-up time was 29.4 months. Control group was consisted of 58 patients (54 girls, 4 boys; mean age 13.1 years, Risser sign 0-2, Th Cobb 19.4°, L/TL Cobb 19.2°), that were retrospectively analyzed and performed general or no exercises. Compliance was self-reported. Statistical analysis was performed by paired t-test. RESULTS For PSSE - Schroth group, 103 patients (63.2%) remained stable, 39 (23.9%) improved and 21 (12.9%) worsened. The success rate (87.1%) was significantly higher compared to Control group (P=0.002), where 15 subjects (25.9%) were stable and 43 (74.1%) worsened. Similarly, 16 patients (9.8%) from PSSE - Schroth group finally needed a brace, while 39 (67.2%) from control group (P=0.01). CONCLUSIONS PSSE - Schroth reduced the risk of progression in Adolescent Idiopathic Scoliosis (AIS) patients, during early growth. Our results are in accordance with the recently published literature, showing the effectiveness of PSSE and their superiority compared to general exercises or natural history. CLINICAL REHABILITATION IMPACT Scoliosis specific exercises can be the first step of scoliosis treatment in mild curves, to avoid progression and bracing.
Collapse
Affiliation(s)
- Nikos Karavidas
- Department of Physiotherapy, Schroth Scoliosis and Spine Clinic, Athens, Greece -
| | - Paris Iakovidis
- Department of Physiotherapy, International Hellenic University, Thessaloniki, Greece
| | | | - Dimitrios Lytras
- Department of Physiotherapy, International Hellenic University, Thessaloniki, Greece
| | - Konstantinos Kasimis
- Department of Physiotherapy, International Hellenic University, Thessaloniki, Greece
| | - Athanasios Kyrkousis
- Department of Physiotherapy, International Hellenic University, Thessaloniki, Greece
| | - Thomas Apostolou
- Department of Physiotherapy, International Hellenic University, Thessaloniki, Greece
| |
Collapse
|
10
|
Aksu H, Manduz B, Armagan M, Satoglu İS, Hanci V. Early complications in scoliosis surgery and relation to preoperative factors: A single-center retrospective study. Medicine (Baltimore) 2024; 103:e37529. [PMID: 38552046 PMCID: PMC10977596 DOI: 10.1097/md.0000000000037529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 02/15/2024] [Indexed: 04/02/2024] Open
Abstract
In this study, we aimed to investigate the perioperative complications of the patients who underwent scoliosis surgery in our hospital and the factors that may affect the outcome. Between 2014 and 2018, scoliosis patients recorded data was examined retrospectively. Age, gender, height, body weight, comorbidity, Cobb index, scoliosis etiology, operation time, preoperative and postoperative hemoglobin, hematocrit, leukocyte, blood urea nitrogen, creatinine, coagulation value, operation time, level of instrumentation, intraoperative and postoperative blood loss, blood transfusion, intraoperative fluid administration, preoperative pulmonary function test values, blood gas values, urine outputs, hospital (LOS) and post anesthesia care unit stays, complications and mortality rates were examined. The files of 77 patients (48 female, 29 male) were retrospectively analyzed. The average age was 19.54 ± 16.32 years and 98.7% were elective surgery. The mean of LOS was 13.55 ± 9.13 days. As the preoperative hematocrit value decreases, LOS increases significantly. In patients with chronic obstructive pulmonary disease, smokers and high ASA scores, LOS is prolonged in patients with previous operations. As intraoperative colloid administration increased, crystalloid and blood products increased, it was also observed that the amount of crystalloid increased LOS. As the amount of intraoperative colloid or red blood cell administration increases, the duration of surgery and anesthesia increases, also increases the duration of post anesthesia care unit. Compared to patients with complications (n = 29) to the patients without complications (n = 47), it was found that they had longer anesthesia, and surgery times, also longer LOS times (P < .05). Our study showed that chronic obstructive pulmonary disease in the preoperative period, smoking, high ASA score, excessive use of colloid, prolonged duration of surgery and anesthesia, and long intubation durations increase the length of hospital stay. Preoperative comorbidity is directly related to postoperative complications and causes longer hospitalization after reconstructive scoliosis surgery.
Collapse
Affiliation(s)
- Hale Aksu
- Department of Anesthesiology and Reanimation, School of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Busra Manduz
- Department of Anesthesiology and Reanimation, School of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Mustafa Armagan
- Orthopedics and traumatology, School of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - İsmail Safa Satoglu
- Department of Anesthesiology and Reanimation, School of Medicine, Dokuz Eylul University, Izmir, Turkey
- Orthopedics and traumatology, School of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Volkan Hanci
- Department of Anesthesiology and Reanimation, School of Medicine, Dokuz Eylul University, Izmir, Turkey
| |
Collapse
|
11
|
Akçay B, Çolak TK, Apti A, Çolak İ. The Immediate Effect of Hanging Exercise and Muscle Cylinder Exercise on the Angle of Trunk Rotation in Adolescent Idiopathic Scoliosis. Healthcare (Basel) 2024; 12:305. [PMID: 38338189 PMCID: PMC10855408 DOI: 10.3390/healthcare12030305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/18/2024] [Accepted: 01/23/2024] [Indexed: 02/12/2024] Open
Abstract
(1) Background: Semi-hanging and muscle cylinder exercises have been defined as scoliosis-specific corrective exercises. The aim of this study was to evaluate the immediate effect of muscle cylinder and semi-hanging exercises on the angle of trunk rotation in patients with adolescent idiopathic scoliosis (AIS). (2) Methods: Twenty-seven patients with AIS with a mean age of 18.6 years were retrospectively analyzed. The angle of trunk rotation (ATR) values were measured before and after performing semi-hanging and standing muscle cylinder exercises. Both exercises were performed for three to five respiratory cycles. The semi-hanging exercise was performed first, followed by the muscle cylinder exercise, in this order, in all participants. For statistical analysis, the Wilcoxon signed-rank test was used to analyze ATR changes after the exercises, and the Kruskal-Wallis test was used to compare ATR changes according to the main curve location. (3) Results: The thoracic, thoracolumbar and lumbar maximum ATR values were significantly increased after the semi-hanging exercise (p < 0.001) and decreased after the muscle cylinder exercise (p < 0.001). The ATR change was greater in the lumbar region than in the thoracic and thoracolumbar regions. (4) Conclusion: The results of this study of a small group of patients emphasized that one of the scoliosis-specific corrective exercises, the standing muscle cylinder exercise, improved ATR, while the other, the semi-hanging exercise, worsened ATR in patients with AIS. It is recommended that each scoliosis-specific corrective exercise be evaluated and redesigned to maximize the three-dimensional corrective effect, considering the biomechanics of the spine and the pathomechanics of scoliosis.
Collapse
Affiliation(s)
- Burçin Akçay
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bandırma Onyedi Eylül University, Balıkesir 10200, Turkey
| | - Tuğba Kuru Çolak
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Marmara University, Istanbul 34854, Turkey;
| | - Adnan Apti
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, İstanbul Kültür University, Istanbul 34191, Turkey;
| | - İlker Çolak
- VM Medical Park Maltepe, Istanbul 34846, Turkey;
| |
Collapse
|
12
|
Nan X, Kuru Çolak T, Akçay B, Xie H, Zhao L, Borysov M. Results of Gensingen Bracing in Patients With Adolescent Idiopathic Scoliosis: Retrospective Cross-Sectional Feasibility Study. JMIR Rehabil Assist Technol 2024; 11:e50299. [PMID: 38198197 PMCID: PMC10809064 DOI: 10.2196/50299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 10/10/2023] [Accepted: 12/11/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Bracing is an essential part of scoliosis treatment. The standard of brace treatment for patients with scoliosis today is still very variable in terms of brace quality and outcome. The Gensingen brace is a further developed Chêneau brace derivative with individual design, which can be adapted through computer-aided design. OBJECTIVE This study aims to generate a template to obtain a database for prospective multicenter studies study to analyze the results of high-corrective asymmetric Gensingen brace treatment for patients with adolescent idiopathic scoliosis (AIS). METHODS A template for the database was created, which contains the patients' basic data (age, menarcheal status, Risser Sign, curve pattern, and daily brace wearing time), the Cobb angles of curvature, and the cosmetically relevant angles of trunk rotation (ATR). A retrospective review of medical records of patients with AIS, who met the Scoliosis Research Society's inclusion criteria for brace studies, was performed to test the feasibility of the template. Template items were filled in by the researchers. RESULTS Out of 115 patients between 2014 and 2018, the complete data of 33 patients followed up at least 3 months after complete Gensingen brace weaning could be analyzed. The mean age was 12 years, the mean Cobb angle was 33.6°, and the mean Risser value was 0.7 at the beginning of the treatment. The mean improvement in the Cobb angle on in-brace x-ray imaging was -26.1० (80% of in-brace correction). The Cobb angle of the major curvature changed as follows: curve stabilization was achieved in 7 (21.2%) cases, and curve improvement was achieved in 26 (78.8%) cases. None of the patients showed a curve progression. The Cobb angle was significantly reduced in the brace at the end of treatment and at follow-up evaluation (P<.001). ATR improved significantly for thoracic (P<.001) and lumbar curves (P<.001). CONCLUSIONS The database proved to be informative in the assessment of radiological and clinical outcome parameters. The example data set we have generated can be a helpful tool for professionals who work in clinics but do not store regular patient data. Especially with regard to different patient collectives worldwide, different results may be achieved with the same standards of care. In addition, the results of this study suggest that above-average correction effects with a full-time brace application lead to significant improvements in the Cobb angle after brace treatment has been completed.
Collapse
Affiliation(s)
- Xiaofeng Nan
- Nan Xiaofeng's Spinal Orthopedic Workshop, Xi'an Shaanxi, China
| | - Tuğba Kuru Çolak
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Marmara University, İstanbul, Turkey
| | - Burçin Akçay
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bandırma Onyedi Eylül University, Balıkesir, Turkey
| | - Hua Xie
- Schroth Health Technology, Chongqing, China
| | - Liwei Zhao
- National Research Centre for Rehabilitation Technical Aids, Schroth Health Technology, Beijing, China
| | | |
Collapse
|
13
|
Grivas TB, Dadakaridou D, Fokidi SA, Kastrinis A, Kosti M, Mihas C, Oikonomaki M, Theodosopoulos E, Griva AM. A Questionnaire of Physiotherapeutic Specific Exercises of Scoliosis-QPSSE. J Clin Med 2024; 13:318. [PMID: 38256452 PMCID: PMC10816487 DOI: 10.3390/jcm13020318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/26/2023] [Accepted: 01/02/2024] [Indexed: 01/24/2024] Open
Abstract
STUDY DESIGN Creating and psychometric testing of a new QoL Questionnaire about Physiotherapeutic Specific Exercises of Scoliosis (Questionnaire of Physiotherapeutic Specific Exercises of Scoliosis-QPSSE). PURPOSE The purpose of this study is to create a reliable and valid questionnaire for patients suffering from mild and moderate adolescent idiopathic scoliosis (AIS) who have been treated with Physiotherapeutic Specific Exercises of Scoliosis (PSSE) in order to evaluate their quality of life. MATERIALS AND METHODS The developed questionnaire was based on a thorough literature review as well as on authors' experience. It consists of 53 questions, of which 37 have a positive meaning, 15 have a negative meaning, and 1 is a multiple choice question; additionally, there are 6 "open" questions. Except for the multiple choice question, all other questions are answered on a Likert scale ranging from 1 to 5 points. Five represents a positive meaning or very positive one, whereas one stands for a negative meaning or none at all. Questions were developed by the authors who subsequently categorized the 53 questions into the following eight domains: physical functioning, self-image, Physiotherapeutic Scoliosis-Specific Exercises (PSSEs), psychosocial functioning, cognitive functioning, compliance, motivation, and pain. A pilot study was conducted so that we could calculate Cronbach's Alpha based on the outcome. Due to the COVID-19 pandemic, the authors worked through the Zoom online platform to structure the questionnaire. RESULTS Pearson's correlation coefficient was used for all correlations evaluated. P values of less than 0.05 were considered to be significant. Internal consistency was evaluated with Cronbach's Alpha. Although there were very few missing values, accounting for 0.78% of the total values of the questionnaire, the expectation maximization likelihood algorithm was used to impute data. IBM® SPSS® Statistics Software v.25 was used for the analysis. Cronbach's Alpha coefficients for the overall score were 0.84. CONCLUSIONS This original QPSSE was found to be a reliable and valid tool for AIS treated conservatively with PSSE and for the patients' clinicians.
Collapse
Affiliation(s)
- Theodoros B. Grivas
- Department of Orthopaedics & Traumatology, “Tzaneio” General Hospital of Piraeus, 18536 Piraeus, Greece
| | - Dimitra Dadakaridou
- Human Performance Lab, Department of Physical Education & Sports Science, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Stavroula A. Fokidi
- Department of ICU, “Agios Panteleimon” General Hospital of Nikea, 18454 Piraeus, Greece;
| | - Alexandros Kastrinis
- Health Assessment and Quality of Life Research Laboratory, School of Health Sciences, Physiotherapy Department, University of Thessaly, 3rd km Old National Road Lamia-Athens, 35132 Lamia, Greece;
| | - Melpomeni Kosti
- Physiotherapist & Complementary Therapist (Acupuncture), 15123 Athens, Greece;
| | - Constantinos Mihas
- Department of Internal Medicine, Kymi General Hospital—Health Centre, 34003 Evia, Greece;
| | | | | | - Artemis Margarita Griva
- Department of Social Psychology, Neapolis University Pafos, 2 Danais Avenue, 8042 Pafos, Cyprus;
| |
Collapse
|
14
|
Ma RT, Wu Q, Xu ZD, Zhang L, Wei YX, Gao Q. Exercise therapy for adolescent idiopathic scoliosis rehabilitation: a bibliometric analysis (1999-2023). Front Pediatr 2024; 11:1342327. [PMID: 38239594 PMCID: PMC10794515 DOI: 10.3389/fped.2023.1342327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 12/11/2023] [Indexed: 01/22/2024] Open
Abstract
Background Among the conservative treatments for rehabilitation of adolescent idiopathic scoliosis (AIS), exercise therapy has attracted a large number of studies as its advantages of good clinical effect, high operability, high compliance, few side effects and low cost. We conduct a bibliometric analysis of previous research to identify prevalent areas of study and inform research for the future directions in this paper. Methods Relevant publications and reviews were collected using the Science Citation Index Expanded from the Web of Science Core Collection. Information from the included studies was analyzed systematically using VOSviewer and Citespace software to identify patterns regarding publications, keywords, authors, citations, countries, institutions and journals. Results A total of 172 articles published from 1999 to 2023 were identified. Over the last decade, the number of publications has gradually increased, reaching a peak of 21 publications in 2021. China, North America and Western European countries and institutions are leading the way as far as the quantity of publications and the total number of citations are concerned. The current areas of focus are the efficacy of exercise therapy in relation to enhancing the quality of life of adolescents during rehabilitation. Conclusions This is the first bibliometric analysis that provides a comprehensive review of the research trends and advances in exercise therapy for the rehabilitation of AIS. The study identifies latest research frontiers and hot directions, providing a valuable reference for scholars in the field of exercise therapy.
Collapse
Affiliation(s)
- Run-Ting Ma
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
- Key Laboratory of Rehabilitation Medicine of Sichuan Province, Chengdu, Sichuan Province, China
| | - Qiang Wu
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
- Key Laboratory of Rehabilitation Medicine of Sichuan Province, Chengdu, Sichuan Province, China
| | - Zhen-Da Xu
- Department of Computing, The Hong Kong Polytechnic University, Hong Kong,Hong Kong SAR, China
| | - Li Zhang
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
- Key Laboratory of Rehabilitation Medicine of Sichuan Province, Chengdu, Sichuan Province, China
| | - Yi-Xin Wei
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
- Key Laboratory of Rehabilitation Medicine of Sichuan Province, Chengdu, Sichuan Province, China
| | - Qiang Gao
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
- Key Laboratory of Rehabilitation Medicine of Sichuan Province, Chengdu, Sichuan Province, China
| |
Collapse
|
15
|
Si W. Exploring the Effectiveness of Hatha Yoga as a Complementary Treatment for Adolescent Idiopathic Scoliosis: Clinical Effect and Future Research Directions. Int J Yoga 2024; 17:61-64. [PMID: 38899138 PMCID: PMC11185438 DOI: 10.4103/ijoy.ijoy_201_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 01/01/2024] [Accepted: 01/10/2024] [Indexed: 06/21/2024] Open
Abstract
Adolescent idiopathic scoliosis (AIS) is a common spinal deformity that primarily affects adolescents during the key period of growth and development. While traditional treatment methods often involve bracing or surgery, Hatha yoga, a millennia-old practice rooted in Indian tradition, has emerged as a complementary option for AIS cases. This paper explores the potential benefits of Hatha yoga for adolescents with AIS. It also discusses the limitations of existing research, such as the lack of large-scale randomized controlled trials (RCTs), varying yoga protocols, and challenges in blinding participants and researchers. To address these limitations, I propose future research directions, including conducting large-scale RCTs, long-term follow-up studies, standardized yoga protocols, and assessing safety concerns. I also highlight the need for tailored interventions and comparative effectiveness studies to better understand the potential of Hatha yoga in the holistic treatment of AIS in adolescents.
Collapse
Affiliation(s)
- Weichen Si
- Health Management Center, Fengtai District Education Committee of Beijing Municipality, Beijing, China
- Department of Acupuncture, Beijing Direction Community Health Service Station, Beijing, China
| |
Collapse
|
16
|
Fregna G, Rossi Raccagni S, Negrini A, Zaina F, Negrini S. Personal and Clinical Determinants of Brace-Wearing Time in Adolescents with Idiopathic Scoliosis. SENSORS (BASEL, SWITZERLAND) 2023; 24:116. [PMID: 38202978 PMCID: PMC10780905 DOI: 10.3390/s24010116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/11/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024]
Abstract
Adolescent idiopathic scoliosis (AIS) is a three-dimensional spine and trunk deformity. Bracing is an effective treatment for medium-degree curves. Thermal sensors help monitor patients' adherence (compliance), a critical issue in bracing treatment. Some studies investigated adherence determinants but rarely through sensors or in highly adherent cohorts. We aimed to verify the influence of personal and clinical variables routinely registered by physicians on adherence to brace treatment in a large cohort of consecutive AIS patients from a highly adherent cohort. We performed a cross-sectional study of patients consecutively recruited in the last three years at a tertiary referral institute and treated with braces for one year. To ensure high adherence, for years, we have provided specific support to brace treatment through a series of cognitive-behavioural interventions for patients and parents. We used iButton thermal sensor systematic data collection to precisely analyse the real brace-wearing time. We included 514 adolescents, age 13.8 ± 1.6, with the worst scoliosis curve of 34.5 ± 10.3° Cobb. We found a 95% (95CI 60-101%) adherence to the brace prescription of 21.9 ± 1.7 h per day. Determinants included gender (91% vs. 84%; females vs. males) and age < 14 years (92% vs. 88%). Brace hours prescription, BMI, and all clinical variables (worst curve Cobb degrees, angle of trunk rotation, and TRACE index for aesthetics) did not influence adherence.
Collapse
Affiliation(s)
- Giulia Fregna
- ISICO (Italian Scientific Spine Institute), 20141 Milan, Italy; (S.R.R.); (A.N.); (F.Z.)
- Doctoral Program in Translational Neurosciences and Neurotechnologies, University of Ferrara, 44121 Ferrara, Italy
| | - Sara Rossi Raccagni
- ISICO (Italian Scientific Spine Institute), 20141 Milan, Italy; (S.R.R.); (A.N.); (F.Z.)
| | - Alessandra Negrini
- ISICO (Italian Scientific Spine Institute), 20141 Milan, Italy; (S.R.R.); (A.N.); (F.Z.)
| | - Fabio Zaina
- ISICO (Italian Scientific Spine Institute), 20141 Milan, Italy; (S.R.R.); (A.N.); (F.Z.)
| | - Stefano Negrini
- Department of Biomedical, Surgical and Dental Sciences, University “La Statale”, 20122 Milan, Italy;
- IRCCS Istituto Ortopedico Galeazzi, 20157 Milan, Italy
| |
Collapse
|
17
|
Hart DA. Sex differences in musculoskeletal injury and disease risks across the lifespan: Are there unique subsets of females at higher risk than males for these conditions at distinct stages of the life cycle? Front Physiol 2023; 14:1127689. [PMID: 37113695 PMCID: PMC10126777 DOI: 10.3389/fphys.2023.1127689] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/28/2023] [Indexed: 04/29/2023] Open
Abstract
Sex differences have been reported for diseases of the musculoskeletal system (MSK) as well as the risk for injuries to tissues of the MSK system. For females, some of these occur prior to the onset of puberty, following the onset of puberty, and following the onset of menopause. Therefore, they can occur across the lifespan. While some conditions are related to immune dysfunction, others are associated with specific tissues of the MSK more directly. Based on this life spectrum of sex differences in both risk for injury and onset of diseases, a role for sex hormones in the initiation and progression of this risk is somewhat variable. Sex hormone receptor expression and functioning can also vary with life events such as the menstrual cycle in females, with different tissues being affected. Furthermore, some sex hormone receptors can affect gene expression independent of sex hormones and some transitional events such as puberty are accompanied by epigenetic alterations that can further lead to sex differences in MSK gene regulation. Some of the sex differences in injury risk and the post-menopausal disease risk may be "imprinted" in the genomes of females and males during development and sex hormones and their consequences only modulators of such risks later in life as the sex hormone milieu changes. The purpose of this review is to discuss some of the relevant conditions associated with sex differences in risks for loss of MSK tissue integrity across the lifespan, and further discuss several of the implications of their variable relationship with sex hormones, their receptors and life events.
Collapse
|